Obama won.. (Read 1493 times)


Needs more cowbell!

    So, while other things are becoming relatively cheaper, the relative cost of health-care for our society will continue to become a greater percentage of our living expenses.

     

    Will it?  If people are able to seek medical attention when problems are little, they are less likely to have to wait until they are desperate and require $$$ treatment (which is reality for a lot of folks, currently).  My DH is a melanoma survivor.  He went to our PCP when he had a small spot on his forearm.  It was biopsied, quickly diagnosed, and he was treated when his spot was still small, because we have insurance and for him to see our doctor wasn't something that would potentially make us have to choose between his health or a cart-full of groceries.

     

    Had we waited until it was clear that his spot was no mere benign mole it would have cost exponentially more (as it was he still had to have general surgery and lost a lymph node) and it's highly likely that I would be sitting here widowed.

    Kirsten - aka "Auntie Kirsten"

    '14 Goals:

    • 2 olympic distance duathlons -- 6 days apart -- PR at least 1

    • 130#s (and stay there, gotdammit!)


    Interval Junkie --Nobby

      Off the top of my head, I can think of 5 cancer survivors who regularly post in this board and at least 2 who are actively dealing with the "condition".

       

      Let's be careful out there.

       

      If someone found that offensive, I apologize.  It wasn't meant to be.  I wasn't implying that the cost was not worth it.

       

      But I think that's also the third-rail in this type of discussion: one which Spaniel might have touched on.  At what point does the cost of a procedure outweigh the benefits. It's a disgusting calculus.

      2014 Goals:  sub-3 Marathon ("Congrats! It's tough to race with poop in the mind" --Wing)

      Current Status 03/17: Drinking beer and eating crap -- all the things I couldn't do before the marathon

      xor


        You don't say.

         


        A Dance with Monkeys

          Will it?  If people are able to seek medical attention when problems are little, they are less likely to have to wait until they are desperate and require $$$ treatment (which is reality for a lot of folks, currently).  My DH is a melanoma survivor.  He went to our PCP when he had a small spot on his forearm.  It was biopsied, quickly diagnosed, and he was treated when his spot was still small, because we have insurance and for him to see our doctor wasn't something that would potentially make us have to choose between his health or a cart-full of groceries.

           

          It would have cost less had he ignored it and gone in when it was far advanced and he just died.

           

          A disgusting calculus, indeed. But there it is.

           

          A problem is that if everybody went in for every small thing and felt entitled to every test and treatment, we'd be muddled in false positive tests and HUGE costs, for little good. A lot of good research helps us understand where the lines are best drawn between cost and benefit, but research budgets are being slashed AND even with good evidence, loads of folks still feel entitled to getting everything done.


          MoBramExam

            I fear that one of the big assumptions is that with heath insurance coverage, people will take a pro-active approach to their health care.  Sorry, but I just do not see that happening in any significant measure.  If that were true, there would already be better lifestyle choices as cost have increased over recent years.  Americans still tend to want to be "treated" aftet the fact.  Doubt the ERs will see much decrease in traffic.

             

            Cost spead over more people will reduce premiums.  What are the numbers with subsidies factored in?  Will this be a true share the cost aspect of the plan, or will it be just another transfer of the cost?  We shall see.  They obviously think there will be significant resistance in the (voluntarily and involuntarily) uninsured purchasing insurance.  That is evidenced by the IRS enforcement provisions.

             

            In principle, I am in favor of spaniel's solution.  Many procedures can be done within such a system.  People now shop and price for deductibles and co-pays.  They could extend the same energy for the care itself.

             




            Needs more cowbell!

              It would have cost less had he ignored it and gone in when it was far advanced and he just died.

               

              A disgusting calculus, indeed. But there it is.

               

              A problem is that if everybody went in for every small thing and felt entitled to every test and treatment, we'd be muddled in false positive tests and HUGE costs, for little good. A lot of good research helps us understand where the lines are best drawn between cost and benefit, but research budgets are being slashed AND even with good evidence, loads of folks still feel entitled to getting everything done.

               

              For sure.  And we can look at things like the %age of C-sections performed in the US and the huge burden that is on our healthcare system (even though our infant and maternal mortality rates would not suggest that CSs are of such great benefit).  I am at least 90% certain that mine was the result of timetable-style birthing environment -- but my OB was home in time for dinner and left obstetrics not long after my son was born, even though he was only in his 40s when I was under his care.  There are definitely so many scenarios where our current system encourages waste and discourages preventative medicine.

              Kirsten - aka "Auntie Kirsten"

              '14 Goals:

              • 2 olympic distance duathlons -- 6 days apart -- PR at least 1

              • 130#s (and stay there, gotdammit!)

              xor


                I just wish "they" (whoever they are) would fix that deal where you go in for an xray or a ct or an mri and you work hard to ensure that it is "in network" and then... through no action of your own... you get socked with a much gianter bill because your stuff was read by a radiologist who, ooops, isn't in your network even though you had no real choice regarding who reads your stuff.

                 

                When I look at the full-time job I have (better known as "keeping providers and my insurers on the same page and making noise when they aren't"), this is one of those kicks-in-the-shorts which happens repeatedly and is super common to lots of folks.

                 

                Ok then.

                 

                Anyone that wants to talk "disgusting calculus" is welcome to ponder this:

                 

                You take an anti-nausea med that costs 50-200 per pill.

                You proceed to immediately throw up.

                PONDER: do you fish that 50-200 dollar pill out of the puke?

                 

                HMMMMMMM

                 

                xor


                  More disgusting calculus:

                   

                  Iron, after awhile, makes me constipated.

                  Antibiotics, uh, do the opposite (let's euphemistically call it prostipated).

                   

                  You'd think they'd average out and I'd be regular and normal.

                   

                  You'd be wrong.

                   

                  Also, one of the side effects of some types of chemotherapy given for leukemia (and other cancers) is... "may cause leukemia".  Ahhhhhh. So.

                   

                    I just wish "they" (whoever they are) would fix that deal where you go in for an xray or a ct or an mri and you work hard to ensure that it is "in network" and then... through no action of your own... you get socked with a much gianter bill because your stuff was read by a radiologist who, ooops, isn't in your network even though you had no real choice regarding who reads your stuff.

                     

                    When I look at the full-time job I have (better known as "keeping providers and my insurers on the same page and making noise when they aren't"), this is one of those kicks-in-the-shorts which happens repeatedly and is super common to lots of folks.

                     

                    Ok then.

                     

                    Anyone that wants to talk "disgusting calculus" is welcome to ponder this:

                     

                    You take an anti-nausea med that costs 50-200 per pill.

                    You proceed to immediately throw up.

                    PONDER: do you fish that 50-200 dollar pill out of the puke?

                     

                    HMMMMMMM

                     

                    Yeah, what's the big deal about in-network vs. out-of-network providers, especially with a company like Blue Cross?  I bet Universal Healthcare (gasp!) would avoid that.

                    Well at least someone here is making relevance to the subject.

                       

                       

                      ).  Although some govt-payer systems (UK) do just that...the gov't determines if the value provided is worth the price, and may choose not to make a treatment available to the population.  Personally I don't think the society in the US is ready to accept that model.

                       

                       

                       

                      The UK is only one of dozens of universal health care models around the world- to pass that off as the only one is  very misleading.  Again I recommend "The Healing of America" by T. R. Reid.  One of his main points is that you first need to decide that universal  health care is something you want to have as a society, then you design it the way you think it will work best for your country.  There are many different ways to set it up.


                      Fat butt on couch

                        The UK is only one of dozens of universal health care models around the world- to pass that off as the only one is  very misleading.  Again I recommend "The Healing of America" by T. R. Reid.  One of his main points is that you first need to decide that universal  health care is something you want to have as a society, then you design it the way you think it will work best for your country.  There are many different ways to set it up.

                         

                        Read my post again.  It says "some", ie, just not the UK.  The UK was simply given as ONE example as it is one of the best-known of these types of systems.

                         

                        The second half of your post, I totally agree with.

                        "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                         


                        Fat butt on couch

                          It would have cost less had he ignored it and gone in when it was far advanced and he just died.

                           

                          A disgusting calculus, indeed. But there it is.

                           

                          A problem is that if everybody went in for every small thing and felt entitled to every test and treatment, we'd be muddled in false positive tests and HUGE costs, for little good. A lot of good research helps us understand where the lines are best drawn between cost and benefit, but research budgets are being slashed AND even with good evidence, loads of folks still feel entitled to getting everything done.

                           

                          Ah, but if he went in when it was far advanced...young, healthy male, they may have given him a round of IL-2.  The goes, oh I don't know, $100K between the therapy and required in-patient treatment.  Maybe a 3% chance of cure.  So, probably onto the next treatment, we'll say they stay with the immunotherapy route and go with Yervoy...perhaps 5% chance of long-term response and another ~$150K.  So, likely onto the next option.  Let's say they find he has a B-Raf mutation, so probably another $100K for ~9 months of response and ~0% chance of cure at that point.  There have been some exciting advances, but the price we are paying for them is not sustainable (what part of the system is?)

                           

                          Cures for Stage IV cancer have not made a ton of progress (albiet some exciting recent developments that give some hope), although we have done pretty well at giving people extra months to a few years....but that comes with a pretty steep price tag.  I certainly wouldn't say it's wrong to offer that....personally I think the decision should be left up to the patient as to whether they want to continue treatment.  But one thing we do badly in the US is determine when to stop.  I don't have the study in hand, but the number of people who get chemo in the last month or two of their life....when it will give them side effects and keep them stuck in an infusion clinic and feeling like crap...but most likely no benefit... is far, far higher than anywhere else.

                           

                          This is where the whole "death panel" thing went off the tracks...that's not what it was.  IIRC it was supposed to make sure that patients were being presented with ALL options and information, including information about end-of-life decision-making and planning.

                           

                          Someone close to me died of cancer last year.  He was given false hope right up until he was no longer with it enough to understand what was going on.  I found out later that his wife did not realize he was going to die until the day before he died.  He was already back home on hospice, but nobody on his treatment team would have the tough conversation with her/them and kept talking like there was hope he would pull out of it.  After the fact, she was very angry about that and I don't blame her.

                          "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                           


                          A Saucy Wench

                            I have to say I was kind of glad my dad had moderate to advanced Alzheimers when his Stage IV Lung cancer was discovered (some of his dementia was due to metastasis to the brain).  He was lucid enough to say no to treatment and far enough gone with dementia that not one single doctor tried to convince us that treatment was of any potential benefit.   Or maybe I was kind of glad that the lung cancer intervened from a slow spiral into Alzheimers hell. 

                             

                            He pretty much was a healthcare train wreck at the end that could have been a million dollar EOL scenario easily.  Lung Cancer, kidney failure secondary to diabetes, alzheimers, heart failure secondary to diabetes and morbid obesity.   Without the Alzheimers my dad would have taken any kind of treatment they would have been willing to sell him.  He spent his whole life terrified of death.   But not as terrified of death as he was of losing his mind.

                             

                            As it was I am pretty sure his last 6 months racked up about 200-300K and that was with the decision to do minimal stuff. It kicked off with a heart stent to open a blocked artery and then a few MRI's.  Not to mention Assisted Living care.

                            I have become Death, the destroyer of electronic gadgets

                             

                            "When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

                            TheDroppingDead


                              Obama Won= http://1389blog.com/pix/Just-kidding-those-were-our-prices-the-day-Obama-took-office.jpg


                              Interval Junkie --Nobby

                                Obama Won= http://1389blog.com/pix/Just-kidding-those-were-our-prices-the-day-Obama-took-office.jpg

                                 

                                Not that I think the president has much influence over gas prices, but maybe we should look at the trend from more than a single selected point in time.  As you can see, GWB had prices at as high as $4.12/gal during his reign.

                                2014 Goals:  sub-3 Marathon ("Congrats! It's tough to race with poop in the mind" --Wing)

                                Current Status 03/17: Drinking beer and eating crap -- all the things I couldn't do before the marathon